Helicobacter pylori screening: options and challenges

Expert Rev Gastroenterol Hepatol. 2016;10(4):497-503. doi: 10.1586/17474124.2016.1126507. Epub 2016 Jan 5.

Abstract

Helicobacter pylori gastritis is the most frequent infectious disease in the gastrointestinal tract. Clinical sequelae of the infection including peptic ulcer disease, sporadic gastric cancer (GC) and primary B-cell gastric lymphoma (MALT-lymphoma) may develop in up to 20% of the infected individuals. The H. pylori screen-and-treat strategy is addressed to members of communities with high GC incidence, and first-degree relatives of GC patients. For primary GC prevention, H. pylori screen-and-treat is most effective in patients without precancerous conditions. In populations at moderate risk, strategies for GC prevention need to be explored. A special clinical scenario for primary and secondary prevention of H. pylori related benign complications are patients on non-steroidal anti-inflammatory drugs and low-dose aspirin. Vaccination represents another option for eliminating H. pylori infection in the population and a new H. pylori vaccine has shown promising results. However, long-term effects with the use of vaccine are not available.

Keywords: Helicobacter pylori; gastric cancer; non-steroidal anti-inflammatory drugs; peptic ulcer disease; prevention; screening; vaccine.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Vaccines / therapeutic use
  • Bacteriological Techniques*
  • Gastritis / microbiology
  • Gastritis / prevention & control
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / therapy
  • Helicobacter pylori / immunology
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Mass Screening / methods*
  • Predictive Value of Tests
  • Risk Factors
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / prevention & control
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Bacterial Vaccines